DERMAL FILLERS (RESTYLANE / JUVEDERM) AFTER-CARE INSTRUCTIONS
Following your treatment with dermal fillers, it is important not to touch the treated area or apply make-up for at least six hours. This is to reduce the risk of injection-site infection.
Please bear in mind that immediately after treatment, some common anticipated injection-related reactions can occur. These reactions are temporary and typically resolve within 7-14 days.
However, in order to allow the skin to recover more efficiently, the following advice may prove to be useful:
1. Redness - A clean, light make-up can be applied to cover any redness after the initial six-hour recovery period.
2. Swelling - Do not expose the treated area to intense heat (e.g. solarium and sunbathing) or to extreme cold for one week following treatment. A clean cool pack can be applied directly to the treated area. It has been reported that non-prescription anti-inflammatory analgesia may prove useful in the reduction of swelling so long as you are medically suitable to take them. However, bruising may be enhanced and/or prolonged with the use of NSAIDs.
3. Bruising - If you are using aspirin or similar medication, be aware that the likelihood of bruising may increase. It has been reported that Arnica** cream and/or tablets help to minimize bruising. Arnica cream can be applied directly to bruising and may help the bruise resolve more quickly. Make-up can be applied to cover bruising following the initial six-hour post treatment period.
4. Discomfort - Following treatment, the area can feel tender from the injection. Non-prescription analgesia like Tylenol can be taken.
5. Itching - Following treatment the treatment area may feel slightly itchy for 7-14 days. Non-prescription anti-histamines like Claritin may reduce itching.
BOTOX / DYSPORT AFTER-CARE INSTRUCTIONS
After your treatment, you may have some redness and swelling. This will normally last less than seven days. A cold compress may be used immediately after treatment to reduce swelling.
Avoid touching the treated area within six hours following treatment. After that, the area can be gently washed.
Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappears.
If you have previously suffered from facial cold sores, there is a risk that needle puncture could contribute to another recurrence.
Avoid exercise and alcohol for six hours after treatment.
Having a follow-up treatment before the product has fully dissipated may enhance the lasting effect. Please call us for an appointment.
Avoid the following facial treatments: microdermabrasion, facials, massages, and waxing—until at least 12 hours post treatment.
Avoid taking a nap for four hours because pressure on the injection site could cause the product to shift.
One week prior to your next treatment, avoid taking St. John’s Wort, high doses of vitamin E supplements, aspirin, and non-steroidal anti-inflammatory medications, such as ibuprofen and Advil. These agents may increase bruising and bleeding at the injection site.
SKIN AFTER CARE
The skin has been deep cleaned, stimulated and nourished. Avoid picking, squeezing pimples or touching the area.
Do not apply make-up for at least 8 hours if possible.
Avoid sun exposure and any further overstimulation and heat treatments for at least 12 hours.
Avoid perfumed products.
No depilation (hair removal) should take place after a facial.
A. Pre-Microdermabrasion Instructions
Do not use Retin-A or other exfoliating creams 24 to 72 hours (1 to 3 days) prior to your treatment.
Avoid sun tanning or tanning creams/sprays for at least a week before treatment.
You must NOT have recently had laser surgery or used Accutane.
Clients who have had a recent chemical peel or other skin procedure, such as collagen injections, should wait 2 to 3 weeks before undergoing microdermabrasion.
Prospective clients should also retain from waxing or tanning the skin to be treated for a few weeks prior to microdermabrasion treatment.
Wash face and neck with non-oily, no-soap based cleanser before each scheduled treatment.
B. Post-Microdermabrasion Instructions
To maximize microdermabrasion recovery time and results it is important to follow all post-procedure instructions below:
Keep the new skin clean and moisturized.
Anti-inflammatory creams or cold compresses may be used as necessary.
Use a gentle cleanser.
Trauma such as scratching or picking the treated area should be avoided.
It is important to avoid irritating the treated skin with harsh chemicals, rubbing or tanning for a week.
Although some peeling may occur in the treated areas, moisturizer should help minimize this effect.
Avoid staying in the sun for at least 7 days after the microdermabrasion treatment to prevent UV rays from damaging your skin which slows down the recovery.
Clients who absolutely cannot avoid sun exposure should use a broad-spectrum sunscreen with an SPF of 30 or higher.
Do not use glycolic, alpha hydroxy, beta hydroxy, retinol, benzoyl peroxide or topical acne medications for 24-48 hours following treatment.
You may resume prescription retinoid products (Retin A, Renova, Tretinoin, Avita, Alustra or other brands of Tretinoin and other prescription retinoid products (Adapalene, Avage, Differin, Tazorac, Tazarotene) 3-7 days after last microdermabrasion treatment or as instructed by your technician.
If you are receiving a series of treatments, do not resume any of these products until after you have completed your last medical microdermabrasion treatment.
If you have any questions or concerns, please call us at (714) 888-5656.
If you have any medical questions after hours please call (714) 462-8383.
How does BOTOX® Cosmetic work?
BOTOX® Cosmetic targets one of the underlying causes of frown lines and crow’s feet—the repeated muscle contractions from frowning and squinting over the years. BOTOX® Cosmetic is injected into these muscles to temporarily reduce muscle activity. After an injection, you will begin to notice a visible smoothing of your crow’s feet lines and frown lines between your brows.
When will I see results? You may begin to notice results within 24 to 48 hours for moderate to severe frown lines, with results lasting up to 4 months.
Will BOTOX® Cosmetic make me look like I’ve had work done? BOTOX® Cosmetic is a technique-sensitive treatment. You should not lose the ability to show expression when you are treated by someone who is licensed, trained, and a medical expert in facial anatomy. It is important to talk to us about the results you want from treatment.
Does BOTOX® Cosmetic treatment hurt? Some patients report that being injected with BOTOX® Cosmetic feels like a pinch. We may use ice to numb the treatment area. If you are concerned about discomfort, we may apply a topical numbing cream before administering your treatment.
What are common side effects? Three percent of patients experienced eyelid drooping in the frown lines studies and 1% of patients experienced eyelid swelling in the crow’s feet studies. Other possible side effects include: dry mouth; discomfort or pain at the injection site; tiredness; headache; neck pain; eye problems: double vision, blurred vision, decreased eyesight and dry eyes; and allergic reactions.These are not all of the possible serious side effects of BOTOX® Cosmetic. Please see the Important Safety Information including Boxed Warning and Medication Guide.
How long does the treatment take? We will discuss your treatment goals and perform a facial analysis to determine theappropriate treatments for you. The actual injection process takes about 10 minutes.
How many injections will I receive? For the crow’s feet area, 3 areas of the muscle that frames the side of the eye (orbicularis oculi) will be injected. This willbe repeated on the orbicularis oculi muscle on the side of the other eye.
For the frown lines area, there are 5 injections into muscles in your forehead— 1 in the procerus muscle and 4 in the corrugator muscles.
How long is the recovery time after treatment? After your treatment, you can resume your day. There is minimal downtime and we may give you specific aftercare instructions.
Do men receive BOTOX® Cosmetic treatment? Yes. BOTOX® Cosmetic has also been clinically evaluated in male patients. In clinical studies for moderate to severe frown lines, 17.5% of patients treated with BOTOX® Cosmetic were men.In the clinical studies for moderate to severe crow’s feet, male patients comprised approximately 12% of patients treated with BOTOX® Cosmetic.
What is JUVÉDERM?
JUVÉDERM is the smooth gel filler that your doctor uses to instantly smooth away wrinkles. With just one treatment, you’ll get smooth and natural-looking results that last up to a year. JUVÉDERM is manufactured using HYLACROSS technology, creating a smooth-consistency gel. It is infused with lidocaine to improve comfort during treatment. With JUVÉDERM® you get the smooth results you expect, with the improved comfort you want. Everyone will notice, but no one will know.
How does JUVÉDERM work?
Young, healthy-looking skin contains an abundance of a naturally hydrating substance called hyaluronic acid (HA). But as you age, sunlight and other factors can reduce the amount of HA in your skin. The lack of HA causes your skin to lose structure and volume, creating unwanted facial wrinkles and folds – like those parentheses lines around your nose and mouth. Using a dermal filler like JUVÉDERM is a safe and effective way to replace the HA your skin has lost, bringing back its volume and smoothing away facial wrinkles and folds.
What areas are treated with JUVÉDERM?
JUVÉDERM is for injection into the mid to deep dermis (below the outer layer of the skin) for the correction of moderate to severe facial wrinkles and folds. Some examples include:
· Plump up folds that run from the bottom of the nose to the corners of the mouth
· Reduce the “Marionette lines,” the downturned creases in the corner of the mouth
· Augment thin or aging lips
Do you offer free consultations?
Yes, we offer free consultations. If you decide at the time of the consultation that you would like to go ahead with the services, then we can provide those at the same visit.
What is the average amount of JUVÉDERM I will need per treatment?
This will vary from one client to the next. On average, most clients receive 1 or 2 syringes of JUVÉDERM per visit.
How long does JUVÉDERM last?
JUVÉDERM is indicated for up to a year in the nasolabial folds. Beyond that, results vary from client to client. For example, the average lip treatment only lasts for about 6 months due to higher blood flow in that area. The great thing about JUVÉDERM is that a touch-up can be performed any time you like after the previous treatment.
What makes JUVÉDERM different than other dermal fillers?
JUVÉDERM is the only hyaluronic Acid filler approved to last up to one year. The manufacturing process provides high concentration of cross-linked hyaluronic acid for long-lasting results. It also works to create a smooth consistency gel that flows easily into the skin and provides a smooth, natural look and feel. Other hyaluronic acid fillers currently on the market are made of granular consistency gels. JUVÉDERM injectable gel is now formulated with lidocaine, a common anesthetic used to improve the comfort of treatment.
Is JUVÉDERM safe?
Yes. Hyaluronic acid occurs naturally in the body and therefore it also dissolves naturally with time and is integrated into your body’s tissues. Over time, the molecules dissolve and turn into water as they depart without leaving any trace in your body. Much like any cosmetic treatment, it’s important to consult with your doctor before deciding on a JUVÉDERM.
Can JUVÉDERM be personalized to my needs?
One size doesn’t fit all when it comes to wrinkle treatment. A customized treatment plan is important for achieving the best results. That’s why JUVÉDERM is available in two formulations. This allows our healthcare professionals to tailor treatment to meet your unique needs
What should I do to prepare for my appointment?
We recommend that you avoid any medications that can prolong bleeding, such as aspirin and non-steroidal anti-inflammatories (NSAIDs), for at least a week prior to receiving the treatment for wrinkles in order to reduce the risk of bruising and bleeding at the injection site. Please always check with your primary physician to see if discontinuing any medication is appropriate.
* If you want JUVÉDERM filler in your lips, please let us know if you have herpes simplex virus (also known as “cold sores” or “fever blisters”). For your comfort we will recommend that you call your physician for treatment as if you were experiencing an outbreak. JUVÉDERM does not cause outbreaks, but can trigger a non-active outbreak * We will also need to know if you are allergic to Lidocaine prior to your appointment.
How long will the procedure take?
The procedure takes approximately 15-30 minutes.
What should I expect after the treatment?
You may experience pain, tenderness, temporary redness, swelling, bruising, firmness, and bumps at the injection sites. Studies have shown that these are usually mild to moderate in nature and clear up on their own in 7 days or less. If you experience swelling at the injection site, you can apply an ice pack for a brief period.
Are there any restrictions post treatment?
You should avoid the following for at least 24 hours after treatment:
– Strenuous exercise
– Consumption of alcoholic beverages
– Extended exposure to sun or heat
In addition, you and your healthcare professional should discuss the following important treatment considerations in order to help avoid unsatisfactory results and complications when using JUVÉDERM injectable gel:
Patients who are using substances that can prolong bleeding may experience increased bruising or bleeding at the injection site. You should inform our healthcare professionals before treatment if you are using these types of substances.
If laser treatment, chemical peeling, or any other procedure based on active dermal response is considered after treatment with JUVÉDERM injectable gel, there is a possible risk of an inflammatory reaction at the treatment site.
Women should not consider JUVÉDERM if you are pregnant or may become pregnant.
Excessive Sweating (Hyperhidrosis)
Botox treatment for excessive sweating is a life changing procedure that works brilliantly. It is a procedure which is much more effective and which is free of significant side effects when comparing to the surgical and abrasive deodorant alternatives.
Many patients tell us that excessive sweating from their armpits or hands is socially very restrictive and embarrassing. It means that they have to wear dark clothes or have to layer their clothes, even in hot weather so that the wet patches under the arms do not show.
How does it work?
Botox treatment for hyperhidrosis works similarly to Botox treatments for facial lines and wrinkles, in that it works by blocking nerve impulses. In the case of hyperhidrosis treatment the Botox is injected through a tiny needle superficially under the skin, where the sweat glands are found, and it works by blocking the nerve impulses going to the sweat glands.
What can this procedure treat?
The classical and most popular treatment is the underarm sweating. Hand sweating is the second most requested procedure, but sweating in areas such as the face, pubic area and feet can also be treated.
How good are the results?
The results are amazing, with most of our patients describing them as life changing. The improvement of sweating is classically 80%-100% and it should last 6-12 months. This really is the holy Grail for our patients who have tried many other things with no success.
Does it hurt?
The treatment only takes 5-10 minutes, and is relatively painless. Numbing cream can be applied to your armpits before treatment, but the needles are so tiny that there is normally no need. Many patients have commented that the sensation is similar to acupuncture and most find it a relatively painless procedure.
Treatment of hand sweating can be more painful making the procedure slightly more difficult for some patients.
Is it safe?
Botox is a protein derived from a bacterium called Clostridium botulinum, having undergone a proven safe and highly effective purification process. It is therefore organic and completely safe. Since the early 1970s it has been used in treating conditions in many fields of medicine including neurology and ophthalmology and it has been used in aesthetic medicine for over 20 years.
In over 30 years of use in medicine, there have never been any reported serious allergic reactions and with such longevity we can say with certainty that there are no long-term side effects. The most important thing to remember is that this treatment is non-permanent and very safe. The Botox is metabolized at the injection site and it does not spread to any other parts of the body.
Are there any side effects?
Treatment of underarm sweating is a procedure with no significant side effects at all. Even though there may be a little bit of tenderness and bruising this is never significant. When treating the hands there is a slight risk of local muscle weakness.
Pre Treatment Instructions:
Shave underarms 24 hours prior to procedure.
Do not consume alcoholic beverages for 24 hours prior to the procedure.
Avoid taking Aspirin or Ibuprofen 24 hours prior to the procedure (please check with your Primary Care Physician if you take either medication on a daily basis for an existing condition)
Post Treatment Instructions:
No deodorant for 12 hours
No heavy exercise for 24 hours
Gently clean and dry your underarm using a mild soap/cleanser.
You may begin to experience results within 7 days, full effectiveness is achieved at 14 days.
Until the maximum effectiveness of the BOTOX® injection is achieved you can continue to use over the counter antiperspirants.
How Does Dysport Work?
Like Botox, Dysport temporarily immobilizes the muscles that cause facial wrinkles. Dysport diffuses a bit farther than Botox from the injection point: one to three centimeters compared to Botox's one centimeter. This means that fewer injections are needed
How long does the treatment last?
Dysport's results begin to appear within one to seven days of treatment, with day three being the median. (In other words, half the people treated with Dysport see wrinkle-smoothing results before day three, and half see results afterward.) Dysport contains less protein than Botox, which means the body should break it down more slowly. The studies are mixed, however, about whether Dysport lasts longer than Botox.
Are there any side effects?
Possible side effects are similar to those of Botox: headache and, if the drug diffuses too widely, drooping eyelids or eyebrows. After the treatment, there will be some reddening and swelling in the treated area. As with any injections, there is always the possibility of bruising.
Is Dysport safe?
At this stage no significant "red flags" have been raised about the safety of Dysport. Of specific concern, allergies and infections have not been seen to a clinically significant degree. The long term risks of using Botulinum Toxin are unknown.
What are Dysport advantages over Botox?
Dysport could act faster. Botox typically takes 3-7 days, Dysport 1-2 days to reduce the appearance of facial wrinkles and lines. Dysport could last longer. In most studies, Dysport is lasting about 3-4 months, about the same as Botox. But, as some medical experts point out, some studies in Europe show Dysport might last even longer than Botox. It hasn't been out long enough here in the USA to know yet. Dysport could cost less. Many doctors are eager to use new injectables which can realistically challenge the virtual Allergan (Botox manufacturer) monopoly over the market. Also, Dysport is slightly less expensive. The cost per bottle to the physician is about 10% less. Dysport diffuses over a wider area when injected and, as such, might be able to treat upper forehead lines more effectively than Botox. However, clinical studies haven't been totally conclusive on this point -- yet.
Dysport unit vs. Botox unit.
The dosing for Botox and Dysport is different. A Botox unit is not equivalent to a Dysport unit, so you can't expect to use the same number of Dysport units that you are used to using in Botox units. The ratio of Dysport to Botox units is generally 2.5-3: 1 (2.5-3 times more Dysport units per Botox unit). There is some variation between the upper and lower face.
What is a Chemical Peel?
A chemical peel is a technique used to improve the appearance of the skin on the face, neck or hands. A chemical solution is applied to the skin that causes it to exfoliate and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin. The new skin is also temporarily more sensitive to the sun. There are three basic types of chemical peels:
Superficial or lunchtime peel: Alpha-hydroxy acid or another mild acid is used to penetrate only the outer layer of skin to gently exfoliate it. The treatment is used to improve the appearance of mild skin discoloration and rough skin as well as to refresh the face, neck, chest or hands.
Medium peel: Glycolic or trichloroacetic acid is applied to penetrate the out and middle layers of skin to remove damaged skin cells. The treatment is used to improve age spots, fine lines and wrinkles, freckles and moderate skin discoloration. It also can be used to smooth rough skin and treat some precancerous skin growths, i.e. actinic keratosis.
Deep peel: Tricholoracetic acid or phenol is applied to deeply penetrate the middle layer of skin to remove damaged skin cells. The treatment removes moderate lines, age spots, freckles and shallow scars. Patients will see a dramatic improvement in skin appearance. The procedure is used on the face and only can be performed once.
When is a chemical peel appropriate? Chemical peels are used to treat a number of conditions including:
Who is not a candidate for a chemical peel?
Generally light-haired and fair skinned people are the best candidates for chemical peel. The procedure does not work as well on dark-skinned patients. The procedure is not recommended for individuals with infections, active skin disease, cut or broken skin, sunburns or active Herpes simplex 1 sores. Other counter-indications include patients who are:
Nursing or pregnant.
Have taken Accutane in last six months.
Have psoriasis, eczema, dermatitis or rosacea.
Have used Retin-A, Renova, prescription skin care products, products that contain ascorbic acid, bleaching or skin-lightening agents or other acid-based products in the last 48 hours.
Are chemical peels painful?
Chemicals peels sting but do not cause a great deal of pain. The gentlest peels use alpha-hydroxy, glycolic, lactic or fruit acids are also gentle. They may cause stinging, redness, irritation and crusting but as the skin begins to adjust all these problems will lessen. Trichloroacetic acids are used for stronger peelings. They remove wrinkles, superficial blemishes and pigment problems. Phenol is the strongest of all treatments and removes deep lines and wrinkles on the face. These type of treatments sting more than those with the gentler acids. After the treatment there may be redness, swelling and irritation but the use of creams and gels will reduce these effects. Also the doctor may prescribe medicines that will help relieve the problems after the peel.
What are the complications or potential side effects of a chemical peel?
Temporary or permanent change in skin color, particularly for women on birth control pills, who subsequently become pregnant or have a history of brownish facial discoloration. Scarring. Reactivation of cold sores
What can I expect after having a chemical peel?
All peels require some follow-up care:
Superficial peels require one to seven days to heal. Treated skin will initially be red and may scale. Lotion or cream should be applied until the skin heals, followed by daily use of sunscreen. Makeup can usually be worn the next day.
Medium peels require seven to 14 days to heal. Treated skin will initially be red and swollen. Swelling worsens for the first 48 hours. Eyelids may swell shut. Blisters may form and break. Skin crusts and peels off in seven to 14 days. Skin must be soaked daily for a specified period, followed by ointment application. Antiviral medication is taken for 10 to 14 days. Mild lotion or cream may be applied. Avoid all sun exposure until healing is complete. Camouflage makeup may be worn after five to seven days. A follow-up appointment will be necessary to monitor progress.
Deep peels require 14 to 21 days to heal. The treated area will be bandaged. Skin must be soaked four to six times daily, followed by ointment application for the first 14 days. Afterwards a thick moisturizer is applied for the next 14 days. Antiviral medication is taken for 10 to 14 days. Mild lotion or cream may be applied. Avoid all sun exposure for three to six months. Camouflage makeup may be worn after 14 days. Several follow-up appointments will be necessary to monitor progress.
Sun exposure and smoking after a chemical peel must be avoided because they can cause unwanted side effects, including infection and scarring.